Comparative Study between Traditional Fasting versus Overnight Infusion of Lipid or Carbohydrate on Serum Insulin Level and Random Blood Sugar in Obese Patients Undergoing Elective On-Pump Coronary Artery Bypass Grafting
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- Category: Vol. 85, September 2017
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Comparative Study between Traditional Fasting versus Overnight Infusion of Lipid or Carbohydrate on Serum Insulin Level and Random Blood Sugar in Obese Patients Undergoing Elective On-Pump Coronary Artery Bypass Grafting, MOHAMED A.M. IBRAHIM, WAEL ELSIOORY, HISHAM HOSNY, ABD EL-MONEM AMR and NORMEEN H. RADY
Abstract
Introduction: Post-operative insulin resistance represents a metabolic disorder. We compared the effects of pre-operative fasting with pre-operative infusion of lipid emulsion or carbohydrate on insulin resistance, insulin level and random blood sugar.
Methodology: In this study, 63 patients subjected to coronary artery bypass grafting surgeries were randomized using closed envelope technique into three equal groups:
•Group (IG) (N=21): Patients will receive 500cc of glucose 10% that contains 50g of glucose and provides patients with 200Kcal with 556mosmoles/L.
•Group (IIS) (N=21): Patients will receive 100cc of SMOF-lipid FRESENIUS KABI (soybean 30%, medium chain triglycerides 30%, olive oil 25%, fish oil 15% and 20mg Vitamin E) that contains 20g lipid and provides patients with 200Kcal with osmolarity of 380mosmoles/L.
•Group (IIIC) (N=21): Patients will be fasting overnight from 11pm till 9am except for clear fluids that will be allowed till 5am.
The outcomes that were investigated are serum insulin level and random blood sugar.
Results: For obese patients who undergone coronary artery bypass grafting surgeries pre-operative infusion of lipid emulsion enriched with medium chain triglycerides and fish oil resulted in reduction in levels of serum insulin and ran-dom blood sugar, when compared with traditional fasting and pre-operative carbohydrate infusion.
Conclusion: Pre-operative infusion of lipid emulsion enriched with medium chain triglycerides and fish oil reduces the levels of TG and VLDL.